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9
FROM NZJM
Potential for health
gain equity
Nina Scott, Ross Lawrenson
The New Zealand Medical Journal; Volume 128 Number 1415
Health inequities are generated
by the health sector as well
as by wider social, economic,
and political systems, and are a
problem affecting everyone in
society.
1
Unfair and avoidable
differences in health outcomes
between the haves and the have
nots, especially for New Zealand
children, is very topical. The use of
ambulatory sensitive hospitalisations
(ASH) rates to assess the impact of
policy changes is also topical.
2
The
article in this issue of the NZMJ by
Matheson et al examining inequities
in ASH rates associated with health
policy changes, tells a complex
and important tale. The authors
demonstrate that for children
aged 0–4 inequities between
ethnic groups in preventable
hospitalisations can, and have been
significantly and rapidly reduced.
Further, the same policy and practice
environment that saw a large
and rapid reduction in inequities
for 0–4 year olds resulted in
improvements at the total population
level and gains for all ethnic and
socioeconomic groups in the same
age band. The potential for health
gain by achieving equity in ASH rates
for all age groups is enormous.
Matheson et al demonstrate the
value of analysis by ethnicity and
Deprivation and illustrate that over
a 12-year period the most dramatic
differences in ASH rates are between
ethnic groups and by social class.
Despite excellent progress, there
remain large and unacceptable
inequities in ASH rates between the
most and least privileged ethnic
and socioeconomic groups of
0–4-year-old New Zealand children.
Achieving equity in ASH rates would
see avoidable hospitalisations for
Māori and Pacific 0–14 year olds fall
from 3,783 and 4,508 per 100,000
respectively to 3,199. There is clearly
large potential for gain for these
children. There is an even larger
potential for gain by achieving equity
in ASH rate in the 45–64 year age
group...